A new report calls for the government to take stronger action to tackle the leading risk factors for ill health following years of slow, uneven and disjointed policy making.  

The analysis published by the Health Foundation is the first review of its kind to assess government policies tackling each of the leading risk factors driving ill health and early death in England, including smoking, poor diet, physical inactivity, and harmful alcohol use.  

It finds that the government’s current approach – which relies heavily on policies that promote individual behaviour change – is insufficient to deliver on its key targets and achieve its ‘levelling up’ mission to improve healthy life expectancy. The report shows trends are going in the wrong direction for many of the major health risk factors:  

  • Childhood obesity rates have risen sharply, and inequalities have widened. 
  • Smoking remains stubbornly high among those living in more deprived areas.
  • Alcohol-related hospital admissions and deaths have increased and rates of harmful drinking have gone up. 
  • Physical activity levels remain low and appear to have declined during the pandemic.  

Government inaction on these leading risk factors has a costly impact not only on the health of individuals but on public services and the wider economy. More than a third of those aged 25–64 in areas of England with the lowest healthy life expectancy are economically inactive due to long-term sickness or disability.  

The review finds recent government policies have focused largely on providing information and services designed to change individuals’ behaviour, rather than ‘population-level’ interventions such as minimum unit pricing for alcohol, regulations to restrict marketing and advertising, and taxes aimed at encouraging reformulation of unhealthy products. This is despite strong evidence that such interventions are most likely to be both effective and equitable in tackling major risk factors for ill health. The review also shows the government’s approach has been uneven across different health risk factors, with particularly weak action taken to tackle harmful alcohol use. 

It goes on to say that policies directly targeting smoking, poor diet, harmful alcohol use and physical inactivity must be underpinned by wider action to improve the circumstances in which people live – reducing factors such as poverty and poor housing and making it easier for people to adopt healthy behaviours.  

The report’s authors say that the upcoming white paper on ‘health disparities’ is a crucial moment for government to present a more coherent long-term strategy to tackle the leading risk factors driving ill health in England. The authors urge government not to water down population-level measures aimed at restricting marketing and advertising of unhealthy foods, following worrying recent media reports.  

New polling from the Health Foundation and Ipsos also signals that the public is not satisfied with the government’s current approach, with just 1 in 5 (18%) agreeing that the government has the right policies in places to improve public health.  

Grace Everest, Policy Fellow at the Health Foundation, said:  

‘If the government is serious about achieving its levelling up mission on healthy life expectancy – not to mention the targets that have been set on obesity and tobacco – then it urgently needs to shift its approach. Government’s focus needs to be on population-level policies that aim to alter the environments in which people live – including taxation, regulation, and public spending – which should be implemented alongside more targeted interventions to support those most in need. Wider action is also needed to address the root causes of poor health and widening inequalities.  

‘The upcoming health disparities white paper is the key moment in this parliament for government to grasp the nettle and present a more coherent, long-term strategy to tackle poor diet, smoking and other leading health risk factors.  

‘With trends going in the wrong direction for many of the major health risk factors, inequalities widening, and key national targets set to be missed, it is clear the approach taken to date has been inadequate.’

Media contact 

Liam Collins 
Liam.Collins@health.org.uk 
07813 554 789

  • The Health Foundation’s new report summarises recent trends for each of the leading risk factors driving ill health in England and reviews national-level policies introduced or proposed by government between 2016 and 2021 to address them. Based on our review, we assess the government’s recent policy position and point towards policy priorities for the future. 
  • The Health Foundation has partnered with Ipsos to deliver a programme of research into public perceptions and expectations of health and social care over the next two years. Every six months, a representative sample of the UK public using the UK KnowledgePanel – Ipsos’ random probability online panel – will be polled, building on previous work on this topic. 
  • The Health Foundation’s new long read highlights key findings on public perceptions of health and care from the first wave of our new programme of polling conducted between 25 November and 1 December 2021, with a total of 2,102 responses from people aged 16+ across the UK, via the Ipsos UK KnowledgePanel, a random probability online panel. The sample was stratified by nation and education and delivered a response rate of 70%. A weighting spec was applied to the data in line with the target sample profile; this included one which corrected for unequal probabilities of selection of household members (to account for two members who may have been selected from one household), and weights for region, an interlocked variable of Gender by Age, Education, Ethnicity, Index of Multiple Deprivation (quintiles), and number of adults in the household. 

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